Provider Demographics
NPI:1528656360
Name:ADENIYI, ADERONKE
Entity type:Individual
Prefix:
First Name:ADERONKE
Middle Name:
Last Name:ADENIYI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ADERONKE
Other - Middle Name:
Other - Last Name:ADENIYI-NMOMA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:375 WHITE PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:EASTCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10709-2826
Mailing Address - Country:US
Mailing Address - Phone:917-494-0399
Mailing Address - Fax:
Practice Address - Street 1:375 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:EASTCHESTER
Practice Address - State:NY
Practice Address - Zip Code:10709-2826
Practice Address - Country:US
Practice Address - Phone:914-337-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-07
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF346625-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily